Fractures of the hand can occur in either the small bones of the fingers (phalanges)
or the long bones (metacarpals). They can result from a twisting injury, a fall, a
crush injury, or direct contact in sports.

Symptoms

This X-ray shows a fracture in the middle of one of the bones of the finger.

A physical examination is done to check the position of the fingers and the condition
of the skin. The examination may include some range of motion tests and an assessment
of feeling in the fingers. This will ensure that there is no damage to the nerves.
X-rays identify the location and extent of the fracture.

Nonsurgical Treatment

Most of the time, the bones can be realigned by manipulating them without surgery.
A cast, splint or fracture-brace is applied to immobilize the bones and hold them
in place. The cast will probably extend from the fingertips down past the wrist almost
to the elbow. This ensures that the bones remain fixed in place.

A second set of X-rays will probably be needed about a week later. These X-rays are
used to ensure that the bones have remained in the proper position.

The cast will be worn for three to six weeks. Gentle hand exercises can probably be
started after three weeks. Afterward, the finger may be slightly shorter, but this
should not affect the ability to use the hand and fingers.

Some hand fractures require surgery to stabilize and align the bones. These fractures
usually break through the skin or result from a crushing accident. An orthopaedic
surgeon can implant wires, screws, or plates in the broken bone to hold the pieces
of the fractured bone in place.

Fractures are seen in the phalanges of two fingers (left). The image on the right
shows how the fractures are repaired with screws.

If the bone changes position while healing, the finger may lose some function.

One of the bones in the ring finger rotated abnormally during the healing process.
When the finger is closed over the palm, the finger rotates but when the fingers are
extended, the finger appears straight.

AAOS does not endorse any treatments, procedures, products, or physicians referenced
herein. This information is provided as an educational service and is not intended
to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance
should consult his or her orthopaedic surgeon, or locate one in your area through
the AAOS "Find an Orthopaedist" program on this website.